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My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare one connection at a time.

Now, let's jump right into the episode.

Alright, here we are from ViVE in beautiful L. A. And we are doing a solution showcase. We're going to talk about testing automation. And we're joined by Mark Scruggs SureTest, President and COO, and Chris Akeroyd with Children's Health.

hey, good morning. Good morning. This is early in the morning for us, and looking forward to this discussion. Chris, we're going to start with you. Talk a little bit about the problem set. I What are we trying to solve with automation in healthcare?

That's a lot we're doing with automation.

We've been automating the business for a while, right? With robotic process automation. But as we look internally at our technology infrastructure, our people finding a way to get more efficiency, better efficiency within the teams was the number one driver. A lot of people in our IT organization focused on Epic.

So that was our first application we went forward with. And, looking to really eliminate a lot of the testing work they're doing.

How much testing work is it?

Quite a bit. We're pretty thorough with it. We do a lot of integrated tests every time we do something. So there's hundreds if not thousands of hours throughout the year that we have the opportunity to.

we did that. We're starting to see some of those benefits now. the other major part of this really comes to quality. It's a consistent approach to testing versus the human approach

of testing. The human approach, because it's the same people that are doing operational work, that also have to do the testing work.

Right.

No fault, but they'll take shortcuts. Try to hurry up and get through something, and so you, you can miss things. the approach may be consistent.

Mark, what are you hearing from Health Systems?

What's the barrier to the discussion? In terms of, are people open to automation? Are they concerned about it taking jobs? Is it hard to sell it? I

would say all of the above. But it's almost like they don't want to give up the control of testing. But I think once they realize that they can get all that time back to focus on production issues, they really appreciate the automation.

So the initial discussion is around, are there higher value activities that you could be working on? And I think the best quote I heard from our project manager at Children's, Jason Steinbeck, was All these Epic analysts got all this time back that they were able to focus on the production issues So they don't have to worry about testing because that was, taken care of for them And they really had all the time that they needed to really then focus on all the issues that they were trying to address How do

you drive the trust the system?

I mean, you implement it in a way that builds trust over time that people go, Okay, yeah, doing what we expect it

It's iterative. lot of communication up front. Being transparent and clear of what we're trying to do and why.

To your point though, people, they're not going to trust it the first time out. They're probably going to do a lot of their own checks and their own validations. And, as we continue to do this, and the tool continues to create value, and the value that we're seeing, which we're starting to see some really good results now.

You start to build that confidence amongst the team, and that trust just naturally comes.

Our leadership embraced it really quick. what Mark was laying out is true. We have a lot of It's value add time, but It's not the right level of work we need our analysts in. So leadership got it, but but yeah, it was, it takes a little bit more to get that message down in a way that can be consumed to the front line.

I would

imagine the ongoing testing. So we're not talking about like somebody sitting there pressing a button going, oh yeah, it's tested, it's good. This is testing that's going on all the time, have you been able to identify challenges along the way with the testing?

Like it said, Hey, this upgrade didn't yield this result that you thought, or Absolutely.

The the tool actually caught some production issues that we had. One of the issues that we found was some poor performance that probably would've taken us months to, to identify and then finally try to root it out.

There's also some billing discrepancies that it caught. We weren't dropping charges. In certain areas, and and I think we were talking about this last night, it was due to the way we tested through a normal method. Of just our analysts doing this, and and just not having the caveat of actually being at that right level of user versus an analyst level view.

I want to talk to you guys about ROI. We eliminate up to 30, 000 labor hours annually. How did you frame it up well within the organization?

It

is a challenge because a lot of our clients don't really measure today how much time they spend on testing. What we've learned is a lot of our clients don't have a good baseline of what they're really spending. But we've done over 20 now, RRI models for clients,

and look at, so you customize them we do.

And we'll say, alright, how many analysts do you have involved? Do you have testing events? How many testing events are you doing a year?

Do track time of those analysts or do they not? They some do, but I

think what we found is they might track the time that the analysts are actually hands on keyboard.

They're not tracking all the time it takes to update the test scripts to do all the analysis for what changes are being made because of the upgrade actual execution of the scripts, the analysis of the, the results of that execution. There's a lot more involved than just fingers on keyboard, the execution.

What we find is our clients might track that time, but it's all the other time that's involved in the overall testing event that they might not be tracking. But we just did a case study with UNC as an example, and they believe they're getting back 17, 000 hours a year, so the equivalent of 8.

5 FTEs. And that was their argument. They had, a budget discussion, and they said, we can either invest in, Automation, with SureTest, or we could go hire eight more analysts and we believe we could forego those hires if we implement the automation. So they chose to do the automation and they believe it really drove the ROI, not only for their existing hospitals, but a lot of the acquisitions that they're taking on, they're doing the same testing for these acquisitions as they would for their core hospitals.

So they were able to leverage the automation for all the acquisitions that they're bringing on over the last couple of years as well.

As a children's hospital, do you do acquisitions? Yeah. I would imagine that's a significant case study.

Done.

Yeah, that would be a great one to look into. we're doing probably about five acquisitions a year, six acquisitions a year.

once you get this platform in place, I would imagine if people start to trust it,

we were talking about this last night of downstream departments that are now part of testing. They're wanting to be involved. They want some of their workflows automated through this as well. So HIM was the conversation. So IS become very good at getting the test scripts to run.

Then it comes to a manual stopping point or HIM department. And they're like, well, we want to play in the same sandbox. Are you

breaking out of the testing arena

we've done a number of RPA use cases for some of our Cerner clients. I think Epic is loosening the restraint on looking at RPA for their clients as well.

We've had some requests for doing some, use cases in RPA. Everything from, we'll use it as part of conversions. So one of our Epic clients does it for when they're converting a physician clinic, they're using it for doing those transactions. We have an EPIC client who's using it to just lookup of authorization and eligibility checks, before patient comes in the next day.

So we've got an automation built that just goes out and looks for eligibility confirmation. That way they know that the, the person has the appropriate insurances before they get seen the next day. There's some simple things like that are pretty straight forward and today is very manually intensive that you can certainly automate.

assume you're platforms as much as possible. You're on Epic.

Yeah, we land platform where we can. The automation conversation though, it's We've had that conversation with Epic quite a bit. We use a different product to do some of that automation. It's a challenge with EPIC at times, but EPIC seems to be getting up to speed a little bit in some of these areas.

It's helpful.

Are there other areas you're looking at in automation right now? .

We've done a lot of internal marketing. building, helping build ROIs what it is. We probably have a dozen automated things today.

the time and the ROI we're seeing back on that is just, it's extensive. And so we're continuing. RevCycle's a good spot. Very long list from them of what they want to do. Had some great conversations really about recently with our heart center. And I think when we look at creating registries, our heart center maintains something crazy, like 12 different registries.

And there's I think about 8 FTEs that do nothing but transcribe data from EPIC into a registry. And it's pretty repetitive, so I think there's a lot of return there that we're going to be able to accomplish of getting some nurses back to something better than transcribing data.

Um, Mark,

Chris, Great chat,

appreciate it. Bill, thank you for your time.   📍

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